Provider Demographics
NPI:1750510053
Name:BARBER, SHELLEY R (PSYD)
Entity Type:Individual
Prefix:
First Name:SHELLEY
Middle Name:R
Last Name:BARBER
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:TRIPLER AMC, 1 JARRETT WHITE RD
Mailing Address - Street 2:CHILD AND ADOLESCENT BEHAVIORAL HEALTH 2B
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96859
Mailing Address - Country:US
Mailing Address - Phone:808-433-1264
Mailing Address - Fax:
Practice Address - Street 1:TRIPLER ARMY MEDICAL CENTER, 1 JARRETT WHITE RD
Practice Address - Street 2:CHILD AND ADOLESCENT BEHAVIORAL HEALTH 2B
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96859-5000
Practice Address - Country:US
Practice Address - Phone:808-433-1264
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-08
Last Update Date:2013-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY017348-1103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist